Cao Wu, Guan Bing, Yu Aimin, Xu Li, Wang Ying, Kafle Saroj, Dai Bingyi
a Department of Otolaryngology Head and Neck Surgery , the Second Xiangya Hospital, Central South University , Changsha City , Hunan Province , P.R. China.
b Department of Otolaryngology Head and Neck Surgery , Subei People's Hospital, Clinical Medical College of Yangzhou University , Yangzhou City , Jiangsu Province , P.R. China.
Acta Otolaryngol. 2017 Aug;137(8):862-867. doi: 10.1080/00016489.2017.1300939. Epub 2017 Mar 30.
The optimal surgical approach for sinonasal mucosal melanoma (SNM) remains under debate. We aimed to compare the therapeutic efficacy of traditional open resection and endoscopic surgery for patients with SNM treated at a single center.
Thirty-three patients diagnosed with SNM who underwent surgery between January 1995 and June 2014 at a single institution were retrospectively analyzed; 18 patients were treated using an open resection approach and 15 using an endoscopic resection approach for the primary tumor. The associations between open resection and endoscopic resection with treatment-related survival outcomes were assessed using the Kaplan-Meier method and log-rank test.
The most common presenting symptoms were epistaxis and abstraction; the nasal cavity was the most common anatomic location. The open resection and endoscopic resection groups did not have significantly different demographic or tumor characteristics. Overall survival (p = .66) and disease-free survival (p = .73) were modest and did not differ significantly between the open resection and endoscopic resection groups.
This retrospective study indicates that the endoscopic endonasal approach is an effective treatment for SNM in selected cases and, when performed by a skilled surgeon, can enable successful radical resection with a similar efficacy as traditional open resection.
鼻窦黏膜黑色素瘤（SNM）的最佳手术方式仍存在争议。我们旨在比较单中心治疗的SNM患者采用传统开放切除术和内镜手术的治疗效果。
回顾性分析1995年1月至2014年6月在单一机构接受手术的33例诊断为SNM的患者；18例患者采用开放切除方法治疗原发性肿瘤，15例采用内镜切除方法。采用Kaplan-Meier法和对数秩检验评估开放切除和内镜切除与治疗相关生存结果之间的关联。
最常见的症状是鼻出血和鼻塞；鼻腔是最常见的解剖部位。开放切除组和内镜切除组在人口统计学或肿瘤特征方面无显著差异。开放切除组和内镜切除组的总生存率（p = 0.66）和无病生存率（p = 0.73）相近，且无显著差异。
这项回顾性研究表明，经鼻内镜入路在某些病例中是治疗SNM的有效方法，由经验丰富的外科医生进行时，可实现与传统开放切除相似疗效的成功根治性切除。
